Responder network

ABSTRACT

A variety of methods, medical devices, responder network servers, emergency services interfaces and call center related processes are described that can help improve responder networks designed to get a medical device such as an automated external defibrillator and/or volunteer responders to the scene of a potential medical incident.

CROSS-REFERENCE TO RELATED APPLCATIONS

This application is a Continuation of U.S. application Ser. No.16/562,870, filed on Sep. 6, 2019, which claims the priority of U.S.Provisional Patent Application Nos. 62/731,306 filed Sep. 14, 2018, and62/846,346 filed May 10, 2019, all of which are incorporated herein byreference in their entirety.

FIELD

The present invention relates generally to the creation andimplementation of a public responder network—as for example, a networkof responders willing to respond to cardiac arrest incidents that mayhappen nearby. A variety of methods, devices and software applicationssuitable for supporting and utilizing such a network in the event of anemergency incident are described.

BACKGROUND

Sudden cardiac arrest is one of the leading causes of death. In theUnited States alone, roughly 350,000 people die each year from suddencardiac arrest. It is the leading cause of death for individuals over 40and the #1 killer of student athletes. The most effective treatment forsudden cardiac arrest is the use of CPR coupled with defibrillation.Automated external defibrillators (AEDs) are portable devices designedto automatically check for life-threatening heart rhythms associatedwith sudden cardiac arrest and to send an electrical shock to the heartto try to restore a normal rhythm when shockable heart rhythms aredetected. The two most common conditions treated by AEDs are PulselessVentricular tachycardia (aka VT or V-Tach) and Ventricular fibrillation(VF or V-Fib). AEDs are typically designed such that they can be used bya lay person in situations where professional medical personnel are notavailable.

Given their potential to save lives, automated external defibrillatorshave been deployed in a relatively wide variety of public and privatelocations so that they are available in the event that a person in thevicinity goes in to cardiac arrest. By way of example, AEDs may be foundin corporate and government offices, shopping centers, airports,airplanes, restaurants, casinos, hotels, sports stadiums, schools,fitness centers and a variety of other locations where people maycongregate.

Although the availability of AEDs has increased over the years, theirrelatively high cost tends to limit their placement and many locationsincluding schools, sports fields, and a plethora of other places wherepeople congregate don't have an on-site AED available. Thus there aremany times, locations and events where no AED is available when acardiac arrest incident occurs. Even when an AED is nearby when a suddencardiac arrest incident occurs, the AED is often not used because eitherits presence is unknown or the device seems intimidating to bystanderswho are reluctant to try to use a device that they are unfamiliar within an emergency setting.

A number of efforts have been made to increase the public awareness ofpublic access defibrillators. By way of example, there are a number ofwebsites and downloadable apps that show the location of registered orotherwise known public access defibrillators. A few representativesolutions include Pulsepoint (www.pulsepoint.org); AEDMAP(www.aedmap.org) and HeartS afe (www.heartsafe.org.uk). Although suchefforts can be very helpful, to be used at the time of a cardiacincident, they require a bystander to lookup the location of nearby AEDand go fetch the nearest AED which hopefully is present at its markedlocation and in good working order.

Another effort is Pulse Point Respond(www.pulsepoint.org/pulsepoint-respond/), which is a community basedprogram in which volunteer citizen responders who are trained in CPR andAED use, are informed of nearby cardiac incidents that are occurring inpublic places. The concept behind the citizen responder projects is thata citizen responder may be able to reach a cardiac incident faster thanconventional emergency medical services. This is particularly criticalfor cardiac arrest incidents where statistics show that survival ratesdecrease at a rate of on the order of 10% with each passing minute. ThePulse Point Respond system is tied in with emergency services so thatthe call for citizen responders is triggered by emergency services.

Although these types of systems are clearly beneficial, there arecontinuing efforts to develop additional and improved techniques thatcan further increase public awareness, help shorten cardiac arrestresponse times and/or otherwise improve cardiac arrest survival rates.

SUMMARY

To achieve the foregoing and other objects a variety of methods, medicaldevices, servers, interfaces and call center related processes aredescribed that can help improve responder networks.

In one aspect a response network server identifies a set of medicaldevices to be queried in response to receiving a request for assistance.The request for assistance indicates the location of a potential medicalincident. Status queries are sent to the identified medical devices toverify their current location and operational status. After receiving atleast one status query response an incident alert message is sent toselected responding medical devices and/or selected volunteer responderrequesting assistance at the scene of the incident. In some embodimentsthe medical devices are defibrillators and the request for assistance isa request for defibrillator assistance.

The selection of which devices to send incident alerts messages to canbe based on a variety of factors including the device's distance ortravel time from the incident, the device's reported status, pastincident response history, and/or a variety of other factors.

In some embodiments, the re request for assistance is received directlyor indirectly from an emergency call center. In some circumstances therequest for assistance is received indirectly from an emergency callcenter through an emergency services interface that is configured tocommunicate with a multiplicity of different emergency call centers andto transmit emergency incident data from other devices to themultiplicity of different emergency call centers. In other embodiments,the request for assistance is received directly or indirectly from anapp on a mobile computing device that is at the scene of the potentialmedical incident.

Communications with any particular medical device (e.g. defibrillator)are sent to a communication unit associated with the device. Thecommunication unit may be an integral part of the medical device or partof an independent interface unit that is physically attached to themedical device. In other embodiments, the interface unit may be part ofa base station that the medical device is stored in.

In the context of defibrillators, in some embodiments, status queriesare sent to a relatively large number of defibrillators whereas thenearby incident alert messages may be sent to a selected subset of thedefibrillators that received a status query. In some embodiments, theselected subset only includes defibrillators from which a status queryresponses were received. A variety of different selection and/orfiltering rules can be used to identify the subset of defibrillators toactually be notified of an incident. In various embodiments, selectionof defibrillators to receive an incident nearby message may be based atleast in part on factors such as: whether the defibrillator responded toa status query; the current location and/or current status reported bythe defibrillator; an estimated distance or travel time to the incident;a prior incident response history associated with such defibrillator;and/or a variety of other factors. Similar factors may be used inidentifying volunteer responders to send volunteer incident alerts to.

In some embodiments, the responder network server maintains a databasethat includes the current location and current functional status ofdefibrillators in its network.

In another aspect a defibrillator system is arranged to send a currentstatus message in response to receiving an electronic status query. Whena nearby incident message is received, the system generates a nearbyincident alert that indicates that there is a cardiac emergency nearbyfor which the defibrillator may be useful.

In various embodiments, the nearby incident alert includes an audioalert, a visual alert message or a combination of both. Visual alertmessages may be displayed on a display screen on the defibrillatoritself, or an interface device associated with the defibrillator.

In some embodiments, the visual alert message includes an indicationthat there is a nearby emergency that can use a defibrillator and a GUIwidget that can be selected by a user to indicate the user's willingnessto help. Selection of the GUI widget causes an incident accepted messageto be sent to a responder network server. In some embodiments, a map isdisplayed to show the incident's location.

In some embodiments, a defibrillator receiving a status query respondsby opening a connection with the responder network server over adifferent channel than the status query was received on. A status reportis then sent to the network server via the new connection. In someembodiments, entirely different communications protocols are used in thedifferent channels. For example, a messaging technology such as SMSmessages may be used for the status query whereas an IP communicationsprotocol or other suitable protocol may be used in for the secondchannel.

In some embodiments, the defibrillator system is a portable modulardefibrillator system that includes a base defibrillator unit and adetachable interface unit that is mounted on and detachably attached tothe base defibrillator unit. In some implementations, the interface unitincludes the communication unit and display screen.

In another aspect an emergency services interface is used to facilitatecommunications between various call centers and a responder networkserver. The emergency services interface is configured to communicatewith a multiplicity of different emergency call centers. It is alsoconfigured to receive real-time incident data from connected devices andcommunicate the real-time incident data directly to appropriate ones ofthe emergency call centers. In some embodiments, a request for volunteerassistance generated by an emergency call center is sent to theemergency services interface. The emergency services interface, in turn,sends a request for assistance to a responder network server. Therequest for assistance includes the location of the potential medicalincident.

In another aspect defibrillator incident data may be transmitted from adefibrillator to selected medical personnel and/or facilities via aseries of intermediaries including a medical device network server, anemergency services interface and a call center.

In various embodiments the defibrillator incident data may include oneor more of: an indication of a number of shocks delivered to a patient;information about the nature or timing of each such shock; one or moreECG segments; cardiac rhythm classifications made by the defibrillator'sclassifier and/or any other available information that may be useful tomedical personnel.

In yet another aspect, methods are described for automatically analyzingincident records received from a call center to determine whether anautomated external defibrillator may be useful to an incident referencedby the incident record. When it is determined that an AED may be usefulto an incident, an incident alert is automatically electronicallytransmitted to one or more registered volunteer responders, and/or oneor more automated external defibrillators to encourage responders to goto the scene of the incident.

In another aspect, a call center computer aided dispatch unit havinggraphical user interface widget suitable for selection by a call centeroperator is described. Selection of the graphical user interface widgetcauses the computer aided dispatch unit to transmit a request forautomated external defibrillator assistance. The request for automatedexternal defibrillator assistance including an indication of a locationof a potential cardiac arrest incident for which assistance is desired.The request for automated external defibrillator assistance is a generalrequest that does not identify any specific responder or defibrillatorto be notified of the potential cardiac arrest incident. The request forautomated external defibrillator assistance is sent to a respondernetwork that identifies at least one of (a) a set of defibrillators, and(b) a set of volunteer responders, to notify of the potential cardiacarrest incident.

Similar approaches may be used in conjunction with medical devices otherthan defibrillators.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention and the advantages thereof, may best be understood byreference to the following description taken in conjunction with theaccompanying drawings in which:

FIG. 1A is a schematic diagram illustrating components of a publicresponder network for notifying potential responders of nearby potentialcardiac arrest incidents.

FIG. 1B is a schematic diagram illustrating components of an alternativepublic responder network for notifying potential responders of nearbypotential cardiac arrest incidents that utilizes an emergency servicesinterface.

FIG. 2A is a flow chart illustrating a flow suitable for generating anincident alert to nearby volunteer responders and AEDs in response to arequest for public AED assistance.

FIG. 2B is a flow chart illustrating a flow suitable for initiating arequest for public assistance from the scene of a potential cardiacarrest incident in accordance with one embodiment.

FIG. 2C is a flow chart illustrating a flow suitable for initiating arequest for public assistance from a call to emergency operators about apotential cardiac arrest incident in accordance with another embodiment.

FIG. 2D is a flow chart illustrating another flow suitable forgenerating an incident alert to nearby volunteer responders and AEDs inresponse to a request for public AED assistance.

FIGS. 3A-3G are a sequence of cards illustrating a representative appflow and user interface that facilitates requesting help from nearbypublic responders from the scene of a potential cardiac arrest incidentusing an app that can connect to a public responder network.

FIGS. 4A-4H are a sequence of cards illustrating a representative appflow and user interface for a registered responder receiving andresponding to an emergency nearby alert via an app.

FIGS. 5A-5H are a sequence of cards illustrating a representative appflow and user interface suitable for use in a public access AED that ispart of a public responder network.

FIG. 6 is a schematic block diagram illustrating the integration of anactivate AED response network widget in the context of another emergencycall dispatch architecture.

FIG. 7 is a flow chart illustrating a method of transferring incidentdata from a defibrillator to medical personnel and/or facilities via adefibrillator network server, and emergency services interface and anemergency call center.

In the drawings, like reference numerals are sometimes used to designatelike structural elements. It should also be appreciated that thedepictions in the figures are diagrammatic and not to scale.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention relates generally to the creation andimplementation of a public responder network—as for example, a networkof defibrillators (e.g. AEDs) available for use during a potentialcardiac arrest incident and volunteer responders willing to respond suchan event. A variety of methods, devices and software applicationssuitable for supporting and utilizing such a network in the event of anemergency incident are described. The inventions are described primarilyin the context of a network of defibrillators and volunteers willing torespond to cardiac arrest incidents. However, it should be appreciatedthat a similar approaches and systems can be used in conjunction withresponder networks involving other types of medical incidents,treatments and/or devices.

The Applicant is developing automated external defibrillator systemsthat include a number of connectivity features and/or are well suitedfor use in conjunction with mobile phones. By way of example, U.S. Pat.No. 10,029,109 and U.S. patent application Ser. No. 16/145,657 (each ofwhich is incorporated herein by reference) describe a few such devices.

Components of a responder network of the type contemplated herein arediagrammatically illustrated in FIGS. 1A and 1B. In the embodimentillustrated in FIG. 1A, the network includes a number of AEDs 10 thathave connectivity features which facilitate communications with one ormore servers—which is/are referred to in FIG. 1A as AED response networkserver(s) 20. Some of the AEDs described in the incorporated patents andpatent application work well for this purpose, but the network is not inany way limited to such AED. In some embodiments, some of the AEDs 10may be modular defibrillator systems that include a fully functionalbase defibrillator and an interface unit that is mounted on anddetachably attached to the base defibrillator unit to provide a unitaryportable modular defibrillator. In such embodiments, the interface unitmay include components such as a display screen and a communication unitsuitable for communicating with the AED response network server throughan appropriate communications network. The incorporated U.S. patentapplication Ser. No. 16/145,657 describes some such systems. In otherembodiments, the communications capabilities may be incorporated into abase defibrillator unit itself.

The AED response network server(s) 20 may be arranged to communicatedirectly or indirectly with existing emergency response networks andsystems, including, for example, computer aided dispatch (CAD) systemscommonly used by emergency call/dispatch centers. These are sometimescollectively referred to as emergency services servers (25) and aparticular class of emergency services servers referred to as emergencycall center servers(s) is illustrated in FIG. 1A. Emergency call centersare centers such a Public Safety Answering Points (PSAP) Center, 911call centers in the U.S. and Canada, 112 call centers in Europe, 999call centers in some jurisdictions and other such emergency servicescall centers.

The emergency call/dispatch centers 25 are typically able tocommunication separately with a variety of emergency medical serviceproviders (EMS providers) 27 which may include emergency medicaltechnicians, ambulance services, fire department personnel, etc.

In various embodiments, the AED response network server can be hosted byan advocacy group or a private party such as a defibrillatormanufacturer or an entity that manages a large number of AEDs.Alternatively, the functionality of AED response network server(s) 20could be incorporated into a server (or servers) within an emergencyservices interface (discussed below). In other embodiments, thefunctionality of the AED response server(s) 20 can be incorporated intoother components of public safety and/or emergency response networks.

The network also includes a number of user devices 30 having a user app35 or other suitable software installed thereon that is also configuredto communicate with the AED response network server 20. The user devicesmay take any of a wide variety of different forms including mobilephones, tablet computers, as well as other types of personalcommunication and/or computing devices. The network also has a number ofregistered volunteer responders who have registered to indicate theirdesire to receive notification of nearby emergency incidents for whichassistance may be helpful. In the context of a responder network focusedon sudden cardiac arrest, the responders would presumably and preferablybe trained in CPR and the use of an AED.

The volunteer responders have their own user devices 40 (e.g. smartphones, tablets, or other computing or mobile/personal communicationdevices) which have a responder app 45 or other suitable softwareinstalled thereon with which they can communicate and receivecommunications from the AED response network server 20. Like the userdevices 30 and user app 35, the responder user devices 40 and responderapp 45 may take a wide variety of different forms (e.g. smart phones,tablets, or other computing or mobile/personal communication devices)and they are labeled differently in the drawings merely to highlight thedifferent context that the devices and app are used for. In someembodiments, a single app may be used as both apps 35 and 45 with theprimary difference being whether the user has registered as a volunteerresponder and the functionality of the app that may be accessed aftersuch registration. Of course, in other embodiments separate apps may beprovided. It should be appreciated that there is no need for all of theapps to be the same and/or to come from one source. Rather, theemergency response functionality can be incorporated into a wide varietyof different applications or software components provided by differententities, including different defibrillator manufacturers, differenthealth service providers, different advocacy groups, different emergencyservice providers, different user device manufacturers, etc.

In some specific implementations, the user app may be embodied in theform of an AED app that is designed to be capable of use in conjunctionwith selected defibrillators during the event of an emergency to helpguide a lay responder through the use of the AED and/or to helpfacilitate the transmission of incident information to emergencyresponders and other concerned medical personnel. Thus, for convenience,in much of the discussion below, the app is referred to as an AED app.However, it should be appreciated that the user application software maytake a very wide variety of forms and is not intended to be limited toapps having AED support functionalities.

The AED response network server(s) 20 can also take a wide variety ofdifferent forms and are generally intended to refer to any centralsystems or combinations of systems configured to execute the necessaryfunctionality of the server. By way of example the AED response networkserver may take the form of one or more computing devices, serverclusters, distributed computing nodes on a network or the combinedforces of multiple distinct systems. Such servers can be operated bypublic or private entities of any nature including emergency services,non-profit advocacy organizations, healthcare organizations, medicaldevice companies, government agencies and/or any other suitableentities. The AED response network servers can be dedicated to handlingAED response network actions, they can be integrated into AED managementserver platforms, they can be integrated into components of existingemergency services servers, and/or they can be deployed as part of avariety of other now existing or later developed systems.

FIG. 1B illustrates another representative responder networkarchitecture. This embodiment is quite similar to the embodimentdiscussed above with respect to FIG. 1B except that an emergencyresponse network interface or an emergency services interface 28 servesas an interface between the AED response network server 20 and theemergency call centers 25. In the United States, RapidSOS is currentlythe largest emergency response network interface and is well suited forsuch applications. One particularly desirable feature of RapidSOS isthat they currently have relationships with a large percentage of theemergency call centers in the United States and are already set up tosend incident related data received from other connected devices 29 tovarious call centers—although they do not currently serve as anintermediary between call centers and any defibrillators ordefibrillator networks. Although RapidSOS is mentioned specifically, itshould be appreciated that the same approach can be used with any orwith multiple different intermediaries as appropriate.

When a cardiac arrest incident occurs, the AED response network server20 may receive a request for assistance from public responders. Therequest for assistance can come from a variety of different sources,including from an emergency services server 25 (directly or indirectlythrough an emergency services interface), a user app 35 or from anyother suitable system including other emergency personnel dispatchsystems such as police or fire dispatch systems. FIG. 2A is a flow chartillustrating a flow suitable for generating an alert to nearby publicAEDs and public responders in the event of a potential cardiac arrestincident in accordance with one embodiment.

When a request for assistance is received (step 201), the AED responsenetwork server 20 attempts to identify and select one or more registeredvolunteer responders that are nearby the incident (step 204). The AEDresponse network server also attempts to identify and select one or moreknown connected public AEDs that are nearby the incident (step 209). Theprotocols, processes and algorithms used to identify suitable volunteersand AEDs may vary widely and a few suitable approaches are given asexamples below. The AED response network server then sends an emergencyincident nearby alert to the selected registered volunteer responder(s)that are close to the incident (step 211). The alert may be sent via anyof a variety of different messaging technologies, including Apple IOSand Android push notification services, SMS text messages, other text orvoice messaging protocols, multimedia messaging protocols (e.g., MMS),instant messaging or iMessage technologies, e-mail, etc. If a volunteerresponder is nearby that either (a) has an AED or (b) can readily accessan AED, then they can grab an AED and quickly bring the AED to the sceneof the incident. In many situations, such a volunteer responder who mayhave an AED, or may know the location of a nearby AED, may be able tobring an AED to the scene quicker than a bystander to the incidenttrying to locate and fetch an AED.

In parallel with the notification of any nearby volunteer responders,emergency alert notifications may also be sent directly to any connectedAEDs 10 that are close to the incident (step 213). As will be explainedin more detail below, the notified AED can issue an emergency nearbyalert signal meant to attract the attention of personnel or bystandersnearby the AED of the incident and request that they bring the AED tothe incident location. Typically, such messages would only be sent toconnected AEDs that have opted into the AED responder network.

In some embodiments, at least some of the AEDs 10 can be queried toreport their current functionality status and current location. Whensuch capabilities, exist, each of the AEDs that are believed to benearby the incident can be queried (pinged) to provide its currentstatus/location as part of AED identification step 209. Each of pingedAEDs then responds giving its current status and location informationand that current information can be used to help determine which AEDs tosend an emergency incident alert to in step 213.

After emergency nearby alerts have been sent to any nearby registeredvolunteer responders and/or registered connected AEDs, the AED responsenetwork server can communicate with any responder(s) that agree torespond to the incident as appropriate to help guide them to thelocation of the incident and convey other information that may behelpful in responding to the incident (step 215).

It should be appreciated that there are a number of scenarios wherecausing the AED to issue an emergency nearby alert may result in adefibrillator and possibly even a trained responder arriving at the siteof a cardiac arrest incident faster than would otherwise occur. Forexample, in many circumstances a defibrillator may be positioned at alocation that is near a designated responder—as for example, in thecontext of a school setting, the defibrillator may be positioned near(or in) the office of a coach, administrator, nurse or teacher that is atrained responder. In the context of an office building, thedefibrillator may be positioned near an administrator or other employeethat is a trained responder. When the AED issues an alert, the alert maybe heard by the trained responder. In such circumstances there issignificant value to notifying the potential responder(s) of anemergency incident that may require a defibrillator in real time so thatthey can go to the scene and provide assistance as needed. Even when adesignated responder (or registered volunteer responders) is notimmediately available, there may be other responsible personnel near thelocation of a defibrillator and the alert generated by the AED willnotify such personnel of the occurrence of a cardiac event in theirvicinity that they may be able to help respond to. Again using thecontext of a school setting, other administrators, teachers, coaches orother responsible personnel that happen to be near the defibrillator atthe time an incident can be encouraged to quickly take the defibrillatorto the location of the incident. Still further, there is even value toinforming bystanders (e.g. fans at a sporting event, students or visitorin the school, bystanders in a public space, etc.) that a defibrillatoris needed at a nearby emergency incident since it is possible that sucha bystander may be motivated to take the AED to the location of theemergency. Although the examples above focus somewhat on the context ofa school, it should be appreciated that the same motivations apply in awide variety of different scenarios.

As previously discussed, when the AED response network server 20receives a request for volunteer responders (e.g., step 201 of FIG. 2A)or otherwise determines that a volunteer responder may be useful in aparticular situation, the server will try to identify nearby volunteerresponders and/or nearby AEDs that may be useful for volunteerresponders. (e.g., steps 204 and 209 of FIG. 2A). There are a widevariety of selection protocols that may be used to identify potentialresponders and AEDs.

As discussed above, some connected AEDs have the ability to report theircurrent status and current location. The location can be identifiedbased on any of a wide variety of location services that may beavailable to pinpoint the location of the AED including: GlobalPositioning System (GPS) (or more broadly GNSS) chips within the AED oran interface unit attached to the AED or a cabinet associated with AED;cellular locating technologies; metropolitan beacon systems; etc. Insuch embodiments, the AED response network server can ping each of theconnected AEDs that are believed to be within a designated distance orresponse time of the patient. As suggested above, the designateddistance may be within a defined radius from the incident, or may bebased on more sophisticated measures of distance such as expected path.Alternatively, when available, estimated response times can be used.

The queried AEDs each communicate their functionality status andlocation to the AED response network server to inform whether they arein adequate operating condition to be utilized on a patient, otherwisedefined as “functional AEDs.” Once AED response network server 20identifies the functional AEDs within a defined distance of the patient,AED response network server 20 may send an emergency alert (step 213) toany such AEDs deemed appropriate. It is important to note that if any ofthe AEDs communicate with the AED response network server that they arenot in adequate operating condition, otherwise defined as“non-functional AEDs”, the server will eliminate these AEDs fromconsideration and not send these AEDs an emergency alert. The emergencyalert that a “functional AED” receives activates an audible and/orvisual signal on the identified AEDs signifying that there is anemergency situation for which bystander assistance would be helpful. Ifa bystander notices the alert, they can “accept” the emergencyindicating a willingness to bring the AED to the scene, a map isdisplayed on the AED that the responder can use to navigates to thepatient's location.

Somewhat similarly, if a volunteer responder accepts an emergency, asuitable map may appear on the volunteer's responder device 40 (e.g.,smart phone) and guide the volunteer responder as appropriate. It shouldbe appreciated that there may be several communications back and forthbetween the AED response network server 20 and the volunteer responderas appropriate. For example, the responder may be asked whether theyhave immediate access to an AED. If so, a map may be displayed on theresponder device to guide the volunteer directly to the incident. Ifnot, the map may display the location(s) of available AEDs and guide thevolunteer to a functional AED that is the closest to being on the way tothe incident and then to the incident itself so that the volunteer canbring the AED.

When desired, the AED response network server can also intelligentlydirect volunteer responders in a coordinated manner. For example, if avolunteer that saw an emergency nearby alert on an AED has affirmativelyindicated that they are responding to the incident by bringing the AED,a registered volunteer responder who is closer to the incident butdoesn't have an AED in hand may be directed to proceed directly to theincident rather than diverting out of their way to find an availablepublic AED. Of course, the specific protocols and priorities utilized indirecting multiple volunteer responders can vary widely based on thepriorities and design goals of the responder network management. Thiscan include decisions regarding: how many volunteers and/or AEDs to sendincident notifications to; when to call off additional potentialresponder(s) (if ever) in the event that one or more other respondershave affirmatively indicated that they are responding to the incident;when to terminate further broadcasts of an incident alert (e.g. due toprofessional emergency medical personnel arriving on the scene, or dueto responses by other); how many AEDs to try to bring to an incident;whether and in what circumstances volunteer responders may be directedto travel directly to an incident even if they don't have an AED inhand; etc.

There are a number of ways that the initial request for assistance (201)can be triggered. In some circumstances, the request for assistance maybe generated by a witness or bystander at the scene who expresslyrequests assistance through a user app 35 on their phone. FIG. 2B is aflow chart illustrating a representative workflow suitable forgenerating such a request in accordance with one such embodiment. Inother circumstances, the initial request for assistance may come from anemergency call center or be trigger based on information received fromsuch as system. FIG. 2C is a flow chart in accordance with a secondembodiment illustrating a representative workflow suitable forgenerating a request for assistance based on a call made to emergencyservices (e.g., a 911 call). In still other circumstances the initialrequest for assistance can come from other sources such as police orfire dispatch centers or any other source that is able to communicatedirectly or indirectly with the AED network server 20.

In the embodiment illustrated in FIG. 2B, a user at the scene of apotential cardiac incident opens an application that includes volunteerresponder assistance request functionality (step 223). As suggestedabove, such functionality can be incorporated into an AED app 35 or anyof a variety of other application programs. Such an app may beexecutable on a variety of devices including cell phones, tabletcomputers, defibrillator interface devices, etc.

When the AED app opens, it provides a mechanism for the user to access avariety of features. One such feature is an AED map that shows thelocation of public access AEDs that are nearby the incident (step 225).In some embodiments, the AED map is included in the initial screen thatis shown when the AED app is opened—while in others, a mechanism isprovided for the user to readily access the AED map. The AED map can beparticularly useful in emergency situations in which the witness to anevent does not have immediate access to an AED because the map shows thelocation of any known or registered public access AEDs that are near theuser's location. If extra help is available a bystander can be sent toretrieve the nearest AED.

In addition, if the situation warrants, the user has the ability torequest assistance from any nearby volunteer responders by indicatingthat help, and/or an AED are needed (step 227). Again, this help requestis particularly useful in circumstances in which the user doesn't haveimmediate access to an AED since a volunteer responder that happens tobe nearby the incident may have or have access to an AED that can bebrought to the scene of the incident more quickly than an AED can befound and returned to the scene by a witness to the event. This can beeven more important when the user is alone at the scene of the incidentbecause CPR should typically be performed on the patient and notperforming CPR for an extended period while the user searches for an AEDcan significantly reduce patient survival chances.

The assistance request may be generated by selecting an appropriate GUIbutton or other appropriate GUI construct which causes a help requestmessage to be transmitted to the AED response network server. Themessage indicates that help is desired and provides the location of thesending device with as much detail as is available. A particular exampleof an interface for generating an assistance required request isdescribed below with reference to FIG. 3A et. seq.

The user request for assistance is transmitted to the AED responsenetwork server 20 which initiates a request for public volunteerresponders as described above with reference to FIG. 2A.

If/when the user indicates that this is an emergency situation, the useror a bystander is preferably encouraged by the app to call emergencyservices (e.g., 911 in the United States) if that hasn't already beendone. This step is important to ensure that emergency medical personnelare dispatched to the incident as soon as possible. Such a call toemergency services may optionally be facilitated by the app althoughthat is not necessary in various embodiments because in manycircumstances users or bystanders would be able to independently callemergency services. In still other embodiments, the AED response networkserver can be configured to automatically forward a notification to theemergency call center that is responsible for the patient's location.This is possible because the user's request for assistance messageincludes an indication of the location of the user that initiates therequest for assistance.

The request for volunteer citizen responders can also be initiated by anemergency services call center in response to a call for emergencymedical assistance. By way of example, FIG. 2C is a flow chartillustrating a flow suitable for generating an alert to nearby publicresponders and AEDs that is initiated based on a call made to anemergency operators at a Public Safety Answering Points Center (PSAPCenters—e.g., a 911 call center in the U.S.) in accordance with oneembodiment. In the illustrated embodiment, the process begins when acall is made to emergency operators (e.g. a 911 dispatcher) asrepresented by block 251. The call may be made by a witness or bystanderto a potential cardiac arrest incident and the call effectivelyactivates the emergency response process. Regardless of whether thecaller witnessed the cardiac arrest incident or is told to callemergency services by another party, calling for help ensuresprofessional first responders are dispatched to the emergency as quicklyas possible.

Although it is expected that in most circumstances, the call toemergency services will be initiated by a person, in some instances, thecall may be automatically initiated by an AED itself. For example, someAEDs may be designed to automatically initiate a call to emergencyservices when the AED is activated in an emergency mode or based on someother triggering event such as a user input, the detection of theopening of an electrode pad cartridge, detection of the placement ofelectrode pads, the detection of a shockable cardiac rhythm, etc.

When the emergency operator answers the phone, the operator undergoes aprocess of assessing the type of emergency for which the reported partyis calling as represented by block 253. When appropriate, the operatorwill dispatch emergency services to the scene. In some jurisdictions,the operator helps the caller assess the patient's status to betterunderstand the type of aid that may be required. For instance, if thepatient is unresponsive and not breathing properly, the operator mayinfer that it is possible that the patient has experienced a suddencardiac arrest. In such circumstances, the operator may guide the callerthrough steps of performing CPR and obtaining an AED, if one is present.In parallel, the operator will dispatch emergency services.Additionally, during the call, the operator asks and learns otherimportant details from the caller, such as the location of the patient.In some circumstances, the patient location is determined by asking thecaller. Additionally, many phones, including cellular phones have theability to automatically provide their location to emergency services.

Details about the incident including information provided by the caller,the operator's assessments, the patient's location and other relevantinformation is commonly entered by the operator into an incident recordin a computer aided dispatch (CAD) system. The CAD system shares theincident record with emergency responders, which helps speed up thedispatch process. It also helps professional first responders learnabout the patient's status so that they have some understanding of thesituation before they arrive at the patient's location.

In some implementations, the emergency operator may initiate a requestfor public assistance when appropriate as represented by the left branchof FIG. 2C. During the assessment referenced above, the emergencyoperator can determine whether an AED would likely be useful in thepresent circumstance as represented by decision block 255. Some keyindicators of sudden cardiac arrest include descriptions of the patientbeing unresponsive and not breathing normally. If the emergency operatorrealizes that the patient may have suffered a sudden cardiac arrest andthere is no AED on the scene, the emergency operator may initiate arequest for public assistance via the CAD system as represented by block259. Such a request may be initiated by selecting an appropriate GUIbutton or other GUI construct on the CAD system display. The request isforwarded to the AED response network server 20 which initiates arequest for public volunteer responders as described above withreference to FIG. 2A.

It should be appreciated that most calls to emergency call centers donot relate to potential cardiac arrest incidents and therefore there isno reason to activate the AED responder network. For instance, if theemergency is described as a house fire or a burn victim, an AED wouldn'tbe useful. In such circumstance, the call would be handled in a normalmanner without activating the AED responder network as represented bythe “no” branch from block 255. Since the subsequent operator actionsare not particularly relevant to the present disclosure, the process iseffectively done from the standpoint of the AED responder network asrepresented by block 257.

The described emergency operator initialized call for public assistancecan work very well in circumstances where the controlling authority iscomfortable with the operators making an explicit decision regardingwhether to request assistance from the AED volunteer responder network.However, some jurisdictions may prefer to have that decision made moreautomatically. One such automatic approach will be described withreference to the right branch of FIG. 2C—steps 262-268.

In this approach, the CAD record is analyzed to determine whether an AEDwould likely be useful as represented by block 262. This analysis can beperformed in a variety of ways. For example, many CAD records have anumber of tags that can be helpful in categorizing the incident orotherwise include an overview of the situation. A couple of thecharacteristics that are most relevant to sudden cardiac arrest arethat: (1) the victim is unresponsive or unconscious; and (2) the victimis not breathing or not breathing properly. When the CAD record hasspecific tags for these conditions, the record tags can be searched andthe incident can be categorized as a potential sudden cardiac arrest ornot based on the tag search. If the incident is not categorized as apotential sudden cardiac arrest, then an AED would not likely be useful.If it is determined that an AED would likely not be useful asrepresented by the no branch from decision block 264, no furtheranalysis of the CAD record would be necessary and the process is donefrom the standpoint of the AED responder network.

Alternatively, if it is determined that an AED may be useful (the yesbranch from decision block 264) and the record further contains usefulvictim location data, a request for public assistance may beautomatically initiated by the system as represented by block 268including the patient's location. The request is forwarded to the AEDresponse network server 20 which initiates a request for publicvolunteer responders as described above with reference to FIG. 2A.

In the simple example above, a couple specific CAD record tags weresearched for to determine whether an AED might be useful. In othersituations considerably more logic can be used to make thatdetermination. For example, in some circumstances the operator may haveasked and noted whether an AED is currently available at the incidentlocation. If an AED is already on scene, there may be no reason to askvolunteers responders to bring an AED to the scene. However, in such acircumstance it may still be desirable to request volunteer assistance,although the volunteers may be asked to proceed directly to the incidentrather than obtaining an AED.

It should be appreciated that not all CAD records will include thespecific tags referenced above and in such circumstances the record canbe scanned for keywords and/or other tags can be used, and/or otheranalytic approaches can be utilized as appropriate to facilitate makingthe decision whether to request public volunteer assistance through theAED public responder network. For example, in some implementations, ananalysis engine (not shown) can have a table of keywords that aresearched for that are indicative of cardiac arrest and correspondinglogic that makes the decision regarding whether to initiate a requestfor assistance through the public responder network. Of course, avariety of other criteria can be used as well.

The analysis of the CAD record or other available data can be performedat any of a number of locations. In some implementations, the AEDusefulness determination and request for public assistance initiationresponsibility can be incorporated into the CAD software so that thedecision is made directly at the emergency call center based on theincident record. There are also emergency data clearinghouse serviceswhich take data from local emergency call centers and make that dataavailable in real time as appropriate to a variety of different publicsafety and/or emergency services. In the United States, the most commonsuch service today is RapidSOS. In some embodiments, the AED usefulnessdetermination and automated request for public assistance initiationresponsibility can be incorporated into the servers at suchclearinghouses. In still other implementations, the record or selectrecords or portions of records can be forwarded to the AED respondernetwork server(s) for analysis at that location. In such embodiments,the records, or relevant portions of the records can be forwardeddirectly from the call centers or via an emergency services interfacesuch as RapidSOS.

Referring next to FIG. 2D, another particular implementation of the AEDnotification process of FIG. 2A will be described. The embodiment ofFIG. 2D begins when the AED response network server 20 receives arequest for volunteer responders (block 201). In the describedembodiment, the server 20 maintains a device database that includesrecords for each of the AEDs in its network. Some of the informationstored about the AEDs may include information such as: (a) the device'sgeo-location; (b) whether the AED has been designated as a private AEDor a public access AED; (c) whether the AED's administrator has opted into receiving notifications regarding nearby potential cardiac arrestincidents; (d) whether the AED is designated as a mobile AED or isexpected to be stored at a fixed location; (e) the current status of thedefibrillator, etc. Preferably, the status and location information isupdated on a regular basis, as for example as a result of periodic(e.g., daily) self-test status checks that are reported by the AED tothe server 20.

When the AED is designated as a public access AED, the devicesowner/administrator may designate the hours/days/etc. that it isavailable to the public. For example, if the AED is located inside anoffice building or retail establishment that is only open duringdesignated hours, it may be desirable to indicate that the AED is onlypublically available during those hours so that potential 3^(rd) partyresponders don't try to find an AED in a locked building.

In general, nearby incident messages may be sent to any AED that hasopted in to such notifications. That may include both public access AEDsthat are available to the general public, and private AEDs which may notbe advertised as being available to the general public. There are manycircumstances where a private AED may elect to receive notifications ofnearby incidents. Once such example may be when the AED is a personalAED of a volunteer responder. Another such example may be when the AEDis located in a building or complex that is not publically accessible.Another example is when the AED is located in a person's home.

An AED may also be designated as a fixed location AED or a mobile AED.Fixed location AEDs are expected to be stored at the same locationall/most of the time. In contrast, mobile AEDs are expected to be movedmore often. Some representative examples of mobile AEDs might includeAEDs expected to be kept in a vehicle or carried as part of a safety kit(e.g., by a coach, guide or volunteer responder).

It is expected that most public access AED would be fixed location AEDsthat are expected to be stationed at a fixed location (e.g., in an AEDcabinet at an office building, at a field, at a designated location inand airport, etc.). However that is not a requirement, for example, apolice department might choose to designate AEDs carried in policevehicles as mobile, public access AEDs so that their locations can bedisplayed on an AED map in the event that the officer happens to benearby when a potential cardiac arrest incident occurs. Of course, inother circumstances it may be desirable to designate such devices asprivate.

Returning to FIG. 2D, when the AED response server 20 receives a requestfor volunteers responders (block 201), the request includes thegeo-location of the incident. The AED response server then identifies aset of AEDs that are potentially available to use in responding to theincident. The set of potentially available AEDs may be determined in avariety of ways using a variety of different filtering techniques. Insome embodiments, the set of potentially available AEDs is determined atleast in part by identifying the AEDs in the responder network databasethat are understood to be within a designated range of the incidentbased on the last known location of the AED as stored in the devicedatabase. (Block 272). In some implementations, the fixed rangethreshold is used in all circumstances, while in others the designatedrange threshold may vary based on a variety of factors. For example, insome implementations, the permissible range allocated for devicesregistered as mobile AEDs may be larger than the range allocated forpermanent AEDs. This can be desirable because a mobile AED that islocated in a vehicle may have traveled quite far since it last reportedits status and location to the AED response server. In another example,when the incident location in a rural area that doesn't have a largenumber of AEDs, the range threshold may be larger than when the incidentlocation is within a metropolitan area having a large number ofregistered AEDs. The specific range thresholds used in this initialidentification of potentially nearby AEDs may vary widely. In somesituations, this initial filtering may be quite broad (as for example,50 or 80 miles in some applications) or it may be significantly morefocused (e.g., a few miles or less) as may be appropriate for anyparticular setting and/or class of registered AEDs. In some embodiments,additional or other filtering may be used to identify the set ofpotentially available AEDs.

In step 274, a status query or “check-in” message is sent to each of theidentified AEDs or to any desired subset of such AEDs. (Block 274). Thisis sometimes referred to as “pinging” or “polling” the AEDs. The pingedAEDs each respond with a “current status” message that provides theircurrent location and operational status. (Step 278). This gives the AEDresponse server the latest information about the identified AEDs andeffectively verifies that communications with the devices is possible.The specific current status information transmitted may vary widely, butit preferably includes at least the device's current location andoperational status. The operational status reported may include theresults of the most recent status check performed by the AED. Such astatus report may be very simple (e.g., functional/non-functional) or itmay include more detailed information such as (but not limited to)battery charge level, pad expiration date, recent self-test results,etc. It should be appreciated that the amount of data transferred in theoriginal request (the “check-in” message) and the response (the currentstatus message) are quite small and can therefore be transmitted backand forth quite quickly. The messages may be transmitted using any of avariety of communications protocols supported by the AEDs, including,for example, as SMS messages.

In some embodiments, the AED receiving a status query (block 275)responds to the query by establish a connection with the AED responsenetwork server 20 over a second communication channel that is differentthan the first communications channel over which the status query isreceived. (Block 276). The current status message is then sent over thissecond communication channel (Block 278). In some embodiments, the firstand second communications channels use different communicationsprotocols, although this is not a requirement. For example, the statusquery may be sent/received using a messaging technology (e.g., SMS),whereas the connection may be established using another communicationsprotocol such as an IP protocol (e.g., TCP/IP). There are somesignificant advantages to such a separate channel approach from asecurity standpoint as described in more detail in U.S. provisionalApplication No. 62/895,071, filed Sep. 3, 2019, which is incorporatedherein by reference. Although the separate channel approach worksparticularly well and has some distinct advantages, it is not requiredin other implementations.

As the AED response network server receives current status messages fromthe pinged AEDs (block 279), it effectively develops an updated AED mapwith the current location and operational status of AEDs in the vicinityof the incident.

In some embodiments, a somewhat similar approach may be used to pollregistered volunteer responders to determine/verify their currentlocation and to verify that they their devices can be communicated with(when such location services have been consented to by the volunteerresponder). Alternatively, if the volunteer has consented to other typesof location services, the server may track or determine the volunteers'location in other appropriate manners. For example, most Smartphonessupport location services that allow users to set their preferred levelof location sharing for each app. When a volunteer consents to alwayssharing their location with the AED responder network, the AED servermay have ready access to the volunteer's current location and in suchcircumstances there may be no need to ping the volunteer's device todetermine their current location. Similarly, if the volunteer happens tohave the AED app open and has consented to sharing their location whileusing the AED app, then the server may know the volunteer responderslocation. In other circumstances, the AED responder network server maynot have a practical way of determining the current location of avolunteer. In such circumstances a registered, expected, or last knowregion may be used to determine the likely location of the volunteerresponder. Regardless of the locating approach used, the server maydetermine the location of nearby responders in parallel with itsverification of the location and status of nearby AEDs.

With the location and operational status information in hand, the server20 determines which connected AEDs and/or volunteer responders to sendan Emergency Incident Nearby message as represented by block 280. Thespecific protocols used to select the specific devices/responders toinform of a “nearby” incident may vary widely based on a variety offactors and the perceived needs of any particular implementation. Forexample, in some implementations, the Emergency Incident Nearby messagemay be sent to any and all volunteers/devices that are considered“nearby” the incident. The specifics of what is considered “nearby” maybe widely varied. By way of example, in some embodiments, the EmergencyIncident Nearby message may be sent to any volunteer/device that iswithin a designated radius of the incident. In such cases, thedesignated radius is preferably set such that a responder responding tothe notification can readily get to the incident in time to be useful.In some embodiments, if no volunteers or connected defibrillators areknown to be within a designated radius, then a notification may be sentto the closest known volunteers/connected defibrillator(s) as long asthey are within a second (longer) distance of the incident. Of course,the designated radii may be different based on whether the incidentnotification is to a responder or an AED, whether an AED is a mobile orpermanent AED, whether a volunteer responder is expected, known orbelieved to have an AED in their possession or a variety of otherfactors.

Preferably, any distances used in the initial identification ofpotentially available AEDs (block 272) is greater than any distancesused in the selection of AEDs to be alerted (block 280). This helpsensure a robust pool of AEDs to select from and provides flexibility toimmediately expand the geographic area in which AEDs are notified ifthere are no, or not enough qualified AEDs in the initial field.

The selection of who to send incident alerts to can be based on a numberof factors and rankings in addition to (or in place of) their distancefrom the incident. For example, it may be desirable to estimate the timeit will take for the potential responder to reach the scene and utilizethat knowledge in determining who the alert should be sent to. Such anestimate can be based on factors such as the responder's expected travelspeed (e.g., would they likely walk, run, or are they in a car?), howfast are they likely to walk/run/drive to the scene, etc.), in additionto an estimate of the actual travel distance (or path) a responder islikely to need to travel to reach the incident.

In many cases, the path that a potential responder/AED may need totravel to reach an incident may be quite different than the straightline distance (radius) to the incident. For example, in a city, theresponder may need to travel along sidewalks, roads or walkways insteadof cutting through buildings or lots that they don't have access to. Inthe countryside, a river or other obstacle may prevent a responder fromtraveling a straight line to the incident. Thus, in some circumstancesan estimation of the distance (or path) that each responder is likely toneed to travel to reach the incident may be used in the distancedetermination rather than simply using a radius/straight line distancefrom the responder. Some such approaches are described in U.S.Provisional Application No. 62/834,137 which is incorporated herein byreference.

There is some evidence that it is counterproductive to sendnotifications to too many volunteer responders. This is believed to bedue, in part to alert fatigue. Thus, if a lay responder responds to anincident only to see that they are the 5^(th) volunteer responder andtheir help is not really needed, they may be less likely to respondquickly to a subsequent incident alert. Thus, in some implementations,when multiple potential responders are within range of an incident itmay be desirable or preferable to select a subset of specific respondersto be notified first of a specific incident. That is, the initialincident alert is only sent to the selected set of responders and/orAEDs. If one or more of those responders accept the request to respond,then it may be that no further incident alerts are required for theincident. Alternatively, if none (or not enough of) the initiallynotified responders accept the incident, then notifications can be sentto a second set and so on as deemed appropriate. Such a second set couldbe all nearby responders or another subset in accordance with thedesired notification protocol.

Another criterion that can be considered is the volunteer responder'sincident response history. For example, if a responder has been notifiedof prior incidents, did they respond to the earlier notification(s) ornot? And if so, how quickly did they respond. In general, with otherfactors being the same, it may be more desirable to send an alert to anindividual that has responded immediately to all previous alerts than anindividual that hasn't or has less frequently responded to prior alerts.Another factor could be whether the responder successfully used an AEDin an emergency scenario before. This information can be useful becausesome studies have suggested that a lay responder who has previousexperience reviving a person with an AED is statistically more likely tohave a successful outcome than those who haven't had previous experiencein a real cardiac arrest setting—possibly even exceeding the outcomes oftrained medical personnel who have not had experience using an AED in areal emergency.

The determination of which AEDs to send an incident alert to can bebased on a variety of generally analogous criteria plus a variety ofdifferent more AED specific criteria. For example, factors such astravel path distance, and incident response history can be equallyrelevant for AED selection. The relevance of the incident responsehistory can be appreciated by considering an AED that is stationed in aschool office that has several people trained in AED use vs. an AED thatis stationed in a lightly traffic lobby of a building. In addition,selected AED status information can be used in the AED selection aswell. For example, when the AED response network server has statusinformation about the potentially available AEDs, the server can usethat information in determining whether the AED is an appropriateincident notification target. For example, if the AED is inoperable, itis eliminated from consideration. If the AED's battery is low or itselectrode pads are old but likely operable, the AED's priority level maybe reduced or it may eliminated from consideration if/when other viableoptions exist.

In some embodiments machine learning may be utilized to train an AIbased volunteer responder/AED selection engine that is used to selectthe specific AEDs and volunteer responders to notify of an incident. Anadvantage of the machine learning approach is that the selection modelcan be updated on a regular basis to improve its performance. Over time,the machine learning will inherently weigh factors it determines to havethe greatest impact on positive outcomes more heavily over time therebyimproving the selection engine's performance.

Although a few specific factors have been described, it should beapparent that decisions regarding what specific factors to consider indetermining who and/or what device(s) should be sent a particularincident alert and the relative weighting of these and other factors canall be widely varied to meet the design goals of any particular system.By way of example, U.S. Provisional Application No. 62/834,137 which isincorporated herein by reference describes a variety of responder AEDselection criteria including some of those referenced above and othersin more detail.

Returning to FIG. 2D, the server sends a nearby incident message to eachof the AEDs that have been selected for notification (block 282) andeach of the volunteer responders that have been selected fornotification. In embodiments in which AEDs opened a connection with theAED network server 20 in response to the check-in status query (block276), the nearby incident message may be sent over that communicationschannel. When a nearby incident message is received by an AED (block283) the AED generates a nearby incident alert (block 285) as discussedabove with respect to FIG. 2A. The alert preferably includes both anaudio alert component, and a visual alert component displayed on adisplay associated with the AED. The visual alert preferably includes acard/frame/pane/etc that includes a GUI widget such as an acceptincident button that when selected, informs the server that someone haspicked up the AED and has indicated that they are responding to theincident. The specific text or graphics associated with the acceptincident button or other GUI widget may vary widely, but when theincident is accepted (decision block 287) an incident acceptance messageis sent to the AED server (blocks 288, 289). By way of example, in somespecific interfaces described below, “I can help” button 413 in FIG. 4Band “Navigate to emergency” button 503 in FIG. 5A are good examples ofsuitable accept incident buttons.

Once the incident has been accepted, the AED response network servercommunicates with the AED as appropriate to direct the volunteer to theincident and respond appropriately (blocks 290, 291). By way of example,FIGS. 5A-5H show a representative sequence of cards illustrating an appflow and user interface suitable for directing a responder that haspicked up an AED in response to a nearby incident alert.

The AED network server preferably monitors the incident as it progressesand will terminate the AED alerts if/when assistance or furtherassistance is no longer needed. When the server determines thatresponders (or additional responders) are no longer needed (block 293)the server sends a message to the non-responding AEDs to cancel theirrespective alerts. (Block 295). When an AED receives a cancel alertmessage (block 296) it will cancel the alert (block 297).

There can be a wide variety of different triggers that will cause thenetwork server to cancel a nearby incident alert. For example, theemergency call 25 responsible for initiating a request for assistancemay affirmatively cancel the request when it learns that: emergencymedical personnel (e.g. an EMT, paramedic or ambulance) have arrived onthe scene; or that other defibrillators have been brought to the scene;or it has otherwise been determined that an AED is not (or is no longer)needed. Similarly, a bystander at the incident who initiated a requestfor AED assistance using an app may cancel the request in similarscenarios. In other scenarios the AED network server itself may cancelthe alert for any of a variety of reasons. For example, as suggestedabove, it may be desirable to cancel alerts generated by non-respondingdevice after a designated number of AEDs and/or volunteers haveindicated that they are responding to an incident.

In another example, a responding volunteer may indicate that they havearrived at the scene with an AED by selecting an appropriate GUI widgetsuch as an “I've arrived” button on the AED display or on a volunteerresponder's app. Once the AED network server has been informed that adefibrillator has arrived on the scene (or multiple defibrillatorsand/or volunteers have arrived on the scene if that is deemedpreferable), the AED network server can send alert cancellation messagesto the other alerted AEDs. If desired, AED alert cancellation decisionscan be made independently of volunteer alert cancellation so thatadditional volunteer help can be requested even if addition AEDs are notrequired.

In another example, the AED may be configured to notify the AED serverwhen it is deployed. In such circumstances, the AED network server canbe configured to send alert cancellation messages when it is determinedthat a responding AED has been deployed at the incident location. Suchnotifications can be triggered by any of a variety of different actions,as for example based on any of (1) activating a “power on” button on theAED; (2) the withdrawal of the electrode pads from their storagelocation or the withdrawal of a pad cartridge from the AED; (3)attachment of the pads to a patient; (4) the detection of a cardiacrhythm, etc. Optionally, such notifications can include the location ofthe AED.

In some implementations, any AED that is picked up in response to anearby incident alert may periodically transmit its location to the AEDserver 20. This is useful in helping the server provide appropriateinstructions to the user. When such location updates are available, theAED server may be able to determine when an AED has arrived at the sceneand base alert cancellation messages at least in part on suchinformation.

Nearby incident messages that are sent to volunteer responders may behandled in a manner that is generally similar to the approach describedabove with respect to AEDs. FIGS. 4A-4H show a representative sequenceof cards illustrating an app flow and user interface suitable fordirecting a registered responder to a nearby incident.

The nearby incident message may be sent to the volunteer respondersusing any of a variety of different technologies. In general, volunteerresponders can be expected to have an AED or AED responder app on theircell phones or other mobile communications devices. Most modern cellphone have a notification service that can be used to push notificationsto their users. For Apple devices incorporate the Apple PushNotification service (APNs) and Android devices include a Notificationsservice. Each of these services can be used to push a notification to avolunteer responder that will be displayed on the volunteer's deviceoutside of the app's UI. The notification can be configured to eitheropen the AED app, or take an action directly from the notification. Forexample, in some implementations, the message in the notification can beconfigured to allow the user to accept the incident directly from thenotification by tapping on the notification or a specific button withinthe notification. Alternatively, a notification such as notification 402in FIG. 4A may be configured to open the AED app when the volunteer tapson the notification, and more details about the incident and/or anincident acceptance button 413 can be presented in the app asillustrated in FIG. 4B.

In the description above, the status queries are described as being sentafter the set of potentially available AEDs has been identified.Similarly, nearby incident messages are described as being sent afterthe AED Network Server has identified the AEDs to be alerted. It shouldbe appreciated that these do not necessarily need to be linearlysequential steps. For example, if desired, the server can send statusqueries or nearby incident messaged to any selected AEDs as soon as thatdevice is identified as a candidate, regardless of whether all of thepotential candidates have been identified. To that end, it should beappreciated that due to factors such as network latency and devicesettings, there will sometimes be delays between the time a status queryis sent and a responsive status report is received and it can beexpected that the response times of different devices may vary—sometimessignificantly. Thus, when desired, the selection of devices to send anincident alert to can be based on the information then available to theAED network server and may be updated by sending nearby incidentmessages to other AEDs and/or canceling alerts sent to other AEDs asappropriate as new information is received. In a specific example, anyAED that is within a designated (relatively close) range of the incidentcan be sent a nearby incident message notified immediately upon thereceipt of the status report or establishment of a connection.

Further, there may be circumstances where it is desirable to send anearby incident message to selected AEDs based on prestored information.A good example of this is when an AED designated as a fixed location AEDhas recently updated its status and is known to be in good workingcondition. In such circumstances it may be desirable to send a nearbyincident message to the AED immediately without first sending a check-inor status query if the AED has the ability to receive and process suchmessages (e.g., when the AED is not required to initiate the connectionover which the nearby incident message is transmitted). Alternatively,such a nearby incident message can be sent immediately upon establishinga connection when a connection is required.

Referring next to FIGS. 3A-3G, a representative user interface thatfacilitates requesting help from nearly public responders from the sceneof a potential cardiac arrest will be described. These figures show asequence of cards that are appropriate for situations where a witness toa cardiac incident determines that a defibrillator may be required butis not present at the incident location. The described flow contemplatesthat the witness has an AED app (or other applicable emergency app)installed on their mobile phone or other readily available mobilecommunication device.

Initially the user (e.g., witness, bystander, etc.) activates the AEDapp on their mobile device which launches appropriately. In someembodiments, the initial card 310 that appears upon launch may be an AEDlocation map 312 such as the map illustrated in FIG. 3A. Any of avariety of publically available mobile mapping services may be used asthe platform for the location map 312, as for example, Google Maps,TomTom (used e.g. in Apple Maps), MapQuest, etc. The AED location map312 has a location identifier 316 showing the user's current locationand markers 318 that show the location of nearby public AEDs that areregistered or otherwise known to the system. In the illustratedembodiment, the AED map includes an “Alert AEDs” banner 314 that servesas a call for help to nearby volunteer responders. In other embodimentsthe opening card or view may vary and the Alert AEDs functionality maybe accessed in other manners.

Selection of the Alert AED banner 314 causes the app to enter anEmergency Alert Mode and a confirmation pane 320 appears (or expands)requesting the user to confirm that this is an emergency as illustratedin FIG. 3B. The confirmation serves as a validation check to verify thatthe user truly desires to send an alert. In the illustrated embodiment,the desire to issue an alert can be confirmed by selecting the “ConfirmEmergency” button 321. However, it should be appreciated that in otherembodiments, a wide variety of other GUI input mechanisms may be used toconfirm the intention to issue an alert. Selection of the ConfirmEmergency button 321 causes a confirm location pane 325 to be displayedas illustrated in FIG. 3C. The confirm location pane includes a dialogbox that presents the detected location of the user (and thus theemergency) and the user is requested to confirm (or correct) thedisplayed address and input any other location information that might beneeded by a responder, as for example, the floor of a building, and/orthe unit number in an office or apartment complex. Pane 325 alsoincludes a “Confirm Location” button 328 that is selected when the userhas confirmed the location.

In the illustrated embodiment, the Alert is activated when the userselects the Confirm Location button 328 and an “Alerting Community” pane330 is displayed to inform the user that an alert has been broadcast tothe community as seen in FIG. 3D. In the primary described embodiment,the community includes registered volunteer responders and any alertcapable AEDs that are perceived by the system to be close to theincident and therefore most likely to be capable of responding to theincident in a timely manner.

In some embodiments, each of the selections made by the user within theapp are transmitted to the AED response network server 20 so the serverhas visibility of the potential cardiac arrest incident actions. Whenthe server receives confirmation of the incident location it transmitsthe nearby emergency notification to registered volunteer respondersthat are close to the incident and transmits emergency alerts to nearbyAEDs that are capable of receiving and reacting to such alerts. The AEDresponse network server can use a variety of different selectioncriteria and selection algorithms to determine which volunteerresponders and public access AEDs should be notified. For example, insome implementations responders and AEDs within a designated radius ofthe incident are identified as candidates (as for example within a twominute walk, etc.). If no, or very few (e.g. only one) volunteerresponders are within the designated range then the range may beexpanded somewhat in an effort to identify a (or additional) potentialvolunteer responder(s) that may realistically be able to get to thescene of the incident. A similar approach can be used for sending alertsto capable public access AEDs.

In some embodiments, the AED response network server 20 is configured toinform the appropriate traditional emergency services of the incident inparallel with notifying the volunteer network.

After the alert has been generated, the display may revert to the homescreen (e.g., map card 312) as seen in FIG. 3E and a variety of featuresthat may be helpful to the user may be displayed thereon. For example,the embodiment illustrated in FIG. 3E, includes a Live Update dialog box341, a CPR Guide button 343, a Contact Emergency Services feature 345and an exit button 347. The Live Update dialog box 341 provides thestatus of the alert and may be updated as appropriate at least untilhelp arrives. For example, in the view shown in FIG. 3E, thenotification in the Live Update dialog box informs the user of how manypotential responders and/or AED were alerted and provides appropriatesuggestions such as a direction to begin CPR. In some embodiments, theLive Update dialog box is updated as appropriate to show that aresponder (or how many) responders (if any) have indicated that they areheaded towards the incident with an AED. In some embodiments, the map312 may be arranged to display the approximate location of suchresponders 348 and/or their progress as they move towards the incidentas seen, for example, in FIG. 3F.

The CPR Guide button 343 or other suitable GUI interface provides a linkto a CPR guide. When the CPR guide is activated it provides graphicaland audio instructions on how to perform CPR. Contact Emergency Servicesfeature 345 may take the form of a button or other GUI interface thatwhen selected by a user will initiate a call to emergency services(e.g., 911 in the United States). It is generally expected thatemergency services would have been contacted well before a user gets tothis point, but the ability to contact emergency services from withinthe app can be useful because it allows emergency services to becontacted without requiring the user to exit the app. Exit button 347provides a mechanism for exiting the Emergency Alert Mode and/oraccessing other functionality of the App. In some embodiments, pressingexit button 347 causes a Confirm Exit pane with a confirm exit buttonthereon that is selected to exit the emergency feature.

In some embodiments, the app is also configured to support some limited,in-app, messaging capabilities. Specifically, the app is configured toallow responders to message the person who generated the emergency alertif, and as, necessary. In some embodiments, the only people that canmessage the initiator of the alert are persons (e.g., volunteerresponders) that have affirmatively indicated that they are respondingto the emergency nearby alert. In other embodiments, EMS responders mayadditionally or alternatively be able to message the person thatgenerated the alert. In general, it is believed that it is desirable tokeep any such messaging to a minimum so as not to distract the personthat generated the alert—particularly when that person is responding tothe incident—as for example by performing CPR. However, there are timeswhen the ability to message may be very helpful—as for example, if theresponder has arrived at the location, but is unable to get into thebuilding, needs more specific directions regarding the specific locationwithin a building, etc. A representative messaging interface isillustrated in FIGS. 3F and 3G.

In FIG. 3F, the message displayed in Live Update dialog box 341indicates that a responder is on the way—which as discussed in moredetail below, is a message that may be generated when a volunteerresponder who received notification of an alert in their area confirmsthat they have received the alert and are on the way to the incidentwith an AED in hand. FIG. 3F also shows a message notification banner351 that indicates that an active responder has sent a message to thealert generator. Selection of the message banner opens a message dialogbox 353 that shows the message, as best seen in FIG. 3G. Of course, avariety of other GUI constructs can be used to access and/or show anyreceived messages.

FIGS. 4A-4H are a sequence of cards illustrating a representative appflow and user interface suitable for notifying a registered responder ofa nearby cardiac incident that can benefit from an AED and for guidingthe responder's response to the incident. As discussed above withreference to FIGS. 2 and 3, when a witness to a cardiac incident orother appropriate source (e.g. emergency services) issues a pushnotification incident alert indicating that an AED is needed, the AEDresponse network server 20 issues an Emergency Nearby Alert toregistered volunteer responders who are believed to be within adesignated useful range of the incident.

FIG. 4A illustrates a representative notification 402 that is displayedon the display screen of each notified potential responder's mobilephone or other device set up to receive such notifications. In someembodiments, an audio alert and/or vibration is generated together withthe displayed alert to help draw the volunteer responder's attention tothe notification. Typically, the user is able to select the nature ofthe sounds that are generated in response to an Emergency Nearby Alertvia appropriate notification settings.

Selection of the notification 402 causes the defibrillator app installedon the responder's device to open or be brought to the foreground asappropriate. In the embodiment shown in FIG. 4B, a dialog box 410 isdisplayed over the base AED map 312. The dialog box 410 explains thatthere is an emergency nearby that needs an AED and asks whether thevolunteer responder can help. A “willing to help” button 413 or otherGUI interface is provided that may be selected by the notified responderto indicate that the responder is able to help. Alternatively, if theresponder is not available to help, they may exit the response flow byselecting a cancel button 416 or other suitable GUI interface. A timingindicator 417 may optionally be provided to indicate how much time haselapsed since the alert was generated.

If/when the responder indicates that they are available to help, the map312 may be updated to show an incident marker 419 that shows thelocation of the incident. The message in the dialog box 410 may beupdated appropriately, as for example, to provide directions to thenearest publicly available AED. As previously mentioned, the map 312shows the location of any nearby registered AEDs 318. Additionally,directions 418 to the nearest AED 318 may be displayed on map 312 asbest seen in FIG. 4D. In some embodiments, the user can obtain detailsabout the location of any registered public access AED (and otherrelevant information) by selecting the icon 318 corresponding to thatAED.

A mechanism is also provided to allow the user to indicate that theyhave an AED. In the illustrated embodiment, that mechanism takes theform of an “I Have an AED” button 424 or other suitable GUI interface.Once the responder has an AED in hand, they indicate that they have theAED be selecting I Have an AED button 424. At that time, they may beprovided with directions to the incident as illustrated in FIG. 4E. Insome situations, the responder will either have their own AED, or mayalready know the location of the nearest AED—and in such circumstances,they may select the “I Have an AED” button 424 to immediately see thedirections to the incident.

FIG. 4E illustrates a representative user interface showing directionsto the incident. In this state, the user interface may include an “IHave Arrived” button 425 or other GUI interface that permits the user toindicate to the server that they have arrived on the scene. In someembodiments, the “I Have Arrived” button only appears when the appdetects that the responder is within a designated range of the incident.

Throughout the process, the messages provided in dialog box 410 may beupdated to display messages that are relevant to the then currentresponse state. For example, when the map 312 is displaying directionsto the nearest available AED, the dialog box 410 may be updated toindicate that action as best seen in FIG. 4D. When the map 312 isdisplaying directions to the emergency, the message in the dialog box410 may be updated to indicate that action as seen in FIG. 4E.

In some embodiments, a message button 427 may be provided to allow theresponder to directly message the initiator of the emergency situationas seen in FIG. 4F. The specific circumstances in which messaging ispermitted may be varied based on the design goals of any responsesystem. For example, in some embodiments, direct messaging may bepermitted at any time after a responder has indicated that they areresponding to the incident. However, in other circumstances it may bedesirable to more strictly limit the availability of messaging fromvolunteer responders to reduce the probability that the initiator of therequest for help will be distracted from administering CPR or otherwiseattending to the victim. Thus, for example, in some embodiments, themessaging functionality may only be activated once the responder iswithin a given distance of the victim or within some other designatedthreshold.

When the messaging button 427 is selected, a messaging interface isdisplayed that allows the responder to directly message the initiator ofthe call for help as illustrated in FIG. 4F. Any of a variety ofconventional messaging widgets can be use to provided the messagingfunctionality. One representative messaging interface 440 is illustratedin FIG. 4G.

Once the responder has arrived, they can exit the emergency at any timeby selecting an exit mechanism. As seen in FIG. 4F, the exit mechanismmay take the form of an exit button 431 or other suitable GUI interface.

In some circumstances the initiator of the request for help may cancelthe request for help before (or after) a volunteer responder arrives.This may be due to the arrival of emergency medical services or anothervolunteer responder. If the request for help is cancelled, otherresponders may be notified of the cancelation via an appropriate messagein the dialog box 410 as seen, for example, in FIG. 4H.

FIGS. 4A-4H illustrated an app flow suitable for notifying volunteerresponders of a nearby emergency incident in which help is needed andfor guiding accepting volunteer(s) to the scene. In some embodiments,emergency incident alerts may also be sent directly to connecteddefibrillators that are physically located nearby the declaredemergency.

Referring next to FIGS. 5A-5H, a representative app flow and response tothe emergency nearby alert from the standpoint of a public access AEDthat is part of a public responder network and located near the incidentwill be described. In this embodiment, when an emergency incident alertdefibrillator help request is received by the AED response networkserver 20, the server identifies any AEDs that it understands to belocated nearby the incident. The server then sends an “EmergencyIncident Nearby” message to each accessible defibrillator that isunderstood to be close to the location of the incident.

When an Emergency Incident Nearby message is received by a defibrillatorit triggers an app installed on the defibrillator to enter an emergencynearby mode that is configured to: (a) inform nearby personnel(potential responders) of the existence of the emergency/request forhelp; and (b) direct anyone responding thereto to the location of theincident.

In some embodiments, when an Emergency Incident Nearby message isreceived, the app will cause the defibrillator to issue an alarm thatcan be perceived by potential responders that may happen to be close tothe defibrillator. The alarm issued by the defibrillator may varywidely. For example, in some embodiments, the notified defibrillatoractivates its display screen and displays an Emergency Nearby messageframe indicating the occurrence of a nearby emergency incident and aprompt encouraging the responder to take the defibrillator to the siteof the emergency. One such Emergency Nearby message frame is illustratedin FIG. 5A. The alarm is preferably delivered in a manner that is likelyto draw attention to the defibrillator. In some embodiments, this caninclude flashing the Emergency Nearby message, or other actions to drawattention to the defibrillator's display screen. In some embodiments, anaudio alert may additionally or alternatively be provided. For example,a series of beeps or other sounds may be played to attract attention tothe defibrillator thereby encouraging bystanders to view the displayedmessage and/or otherwise informing potential responders of the incident.In other embodiments, the audio alert may take the form of a spokenmessage.

In the embodiment illustrated in FIG. 5A, the Emergency Nearby Messageframe 501 includes a GUI button 503 or other GUI element that providesaccess to a navigation frame 510. In some embodiments, the EmergencyNearby Message Frame 501 may also include a timer 506 that displays thetime that has elapsed since the call for help was made. Selection of thebutton 503 in the Emergency Nearby Message frame causes navigation frame510 to be displayed. The navigation frame 510 shows the user how tonavigate to the emergency incident. In the embodiment illustrated inFIG. 5B, the navigation frame 510 includes a map 512 with path 513 shownfrom the defibrillators present location 514 to the incident 516. Thenavigational frame 510 may also display a dialog box 515 displaysinstructions 517 that inform the user what to do until arriving at theemergency location. If desired, the instructions 517 may be updatedappropriately as the user progresses towards the incident. In variousembodiments, the map may be configured to display other information ofinterest as well—as for example: step-by-step instructions regarding howto get to the incident (not shown); an estimate of how long it will taketo get to the incident 518; the timer 506 that displays the time thathas elapsed since the emergency was declared, etc. In some embodimentsin which the map has GPS or other position sensing capabilities, the mapmay also include a location marker that moves with sensed movements ofthe defibrillator to show the users progress towards the incident (notshown).

When the user arrives at the scene or is very close to the scene, theinformation displayed in the Navigation frame display may optionallytransition to an “Arrived” frame 520 which may provide somewhatdifferent information. By way of example, in the embodiment illustratedin FIG. 5C, the map 512 is still displayed but the instructions 517 maychange to indicate how to begin use of the defibrillator and/or the path513 may be replaced by a label 523 indicating that the defibrillator hasarrived on the scene.

Either or both of the Navigation frame 510 and the Arrived frame 520 mayalso include a Message feature (not shown) that allows the user to senda message to the help requester as mentioned above. This can beparticularly helpful when the original message does not include all ofthe information that might be required to get to the scene. For example,if the incident has occurred in a multi-story building, the respondermay need to ask what floor of the building to go to. If the incident hasoccurred in a locked building, the responder may need to ask therequester to let them in the building. Of course a wide variety of othermessages may be useful or appropriate in other particular circumstances.

In some embodiments, the navigation frame 510 may also have an “ActivateDefibrillator” button or other GUI element that causes the defibrillatorto transition to the emergency mode and the defibrillator app totransition to the emergency incident flow. Alternatively oradditionally, in some embodiments, the emergency flow may be activatedby performing an action on the defibrillator such as pulling a tab toaccess the electrode pads, pushing a mechanical button on thedefibrillator, etc.

In some embodiments, the instructions 517 in dialog box 515 may includeGUI buttons or other GUI elements that allow the user to access otherinformation. For example, in the Arrived frame 520 of FIG. 5C, theinstructions 515 include a button 526 that a user may select to getfurther instructions regarding how to activate the defibrillator asrepresented by frame 530 (FIG. 5D) which graphically illustrates thatpulling an electrode pad cartridge tab starts the emergency sequence. Ofcourse, a wide variety of other information (instructional or otherwise)can be made accessible to the user in a similar manner.

When the defibrillator is put to use for treating a cardiac incident,the display controller transitions from the emergency nearby flow to anemergency handling flow. At some stage the emergency use of thedefibrillator (emergency session) will be terminated. The terminationcan be initiated via a number of different mechanisms, as for example bypressing a power on/off button on the defibrillator itself to stop thesession, or by selecting an exit emergency GUI element displayed on thescreen. At the termination of the Emergency session a SessionTermination frame may be displayed. One representative SessionTermination frame 550 is illustrated in FIG. 5E. In some embodiments,the Session Termination frame may include a prompt 552 encouraging theperson possessing the defibrillator to return the defibrillator to itshome location. In the embodiment illustrated in FIG. 5E, the prompt ispart of a GUI button 554 or other GUI element that when selected causesa Return Map frame to be displayed. One suitable Return Map frame 560 isillustrated in FIG. 5F. The illustrate frame 560 includes a map 512having directions to the defibrillator's home location 564. When thedefibrillator is returned to its home location a button or othersuitable element may optionally be selected to terminate the EmergencyNearby flow as illustrated in FIG. 5G.

If the defibrillator was actually used in the incident, the electrodepads will likely need to be replaced and other maintenance or attentionmay be desirable as well. Thus, after the defibrillator is returned toits home position or at any other appropriate time(s), any appropriatestatus notifications may be displayed on the display screen. FIG. 5Hshows a representative status notification frame 570 which informs theowner and other interested individuals that the electrode pads need tobe replaced. In the illustrated embodiment, the pad replacement statusnotification has links to useful information such as instructions or atutorial on how to change the pads and/or to a mechanism for orderingnew pads.

In the description above it is pointed out that the Emergency IncidentNearby message may be sent to any volunteer responders and/or connecteddefibrillators that are considered close to the incident. The specificsof what is considered “nearby” may be widely varied. By way of example,in some embodiments, the Emergency Incident Nearby message may be sentto any volunteer/device that is within a designated radius of theincident. In such cases, the designated radius is preferably set suchthat a responder responding to the notification can readily get to theincident in time to be useful. In some embodiments, if no volunteers orconnected defibrillators are known to be within a designated radius,then a notification may be sent to the closest knownvolunteers/connected defibrillator(s) as long as they are within asecond (longer) distance of the incident.

An AED app in the form of programmed instructions suitable forfacilitating the described response system may be installed in memory onany smart phone, tablet computer, or other mobile communication device,and/or on any other suitable computing device. The programmedinstructions may be configured to be executed by a processor (ormultiple processors) provided by such devices.

Similarly, a defibrillator control app or other suitable defibrillatorresponse software for facilitating the described defibrillator responsesystem may be installed in memory of a defibrillator. The programmedinstructions may be configured to be executed by a defibrillatorprocessor (or multiple processors) or defibrillator controller residenton the defibrillator. In some embodiments, the defibrillator responsesystem is part of a downloadable software app that is configured to bedownload to memory on the AED and installed on the AED to be executed bythe defibrillator processor or controller. Such an app based downloadingand installation process greatly simplifies the ability to update theapp's functionality (and therefore the defibrillator's functionality) ina timely and reliable manner.

In some situations, when the professional first responders arrive to thescene of a reported emergency, they might report the fact that they havearrived to the scene of the reported emergency to the dispatcher. Inother cases, the first responders themselves may update the record forthe emergency incident directly using an emergency dispatch productconnected with the primary CAD system. Once the record for the emergencyincident has been updated with information that professional firstresponders have arrived to the scene of the reported emergency, the CADsystem may update the emergency incident record on the AED responsenetwork servers with this information. The servers might then report tothe responders and AEDs in the network that there is no longer acontinued need for service and emergency response.

AED Map Features

In some implementations the AEDs identified on the AED map may bemarked, highlighted or otherwise identified in a manner that indicatesthe confidence that the AED is actually at its proscribed location. Forexample, in some implementations multiple categories may be identified.Some AEDs are connected devices with location identifying capabilitiessuch as GPS. The system can have a high degree of confidence that suchdevices are actually located where they say they are because they areself reporting their location—which can be verified at any time. In someimplementations, such AEDs can be woken up at regular intervals (e.g.,once per day or other suitable time period) to run any appropriatediagnostics and report its location to the AED response network server20. The diagnostics reports whether the AED is still in good operatingcondition, so the operational condition of the AED is also known. Thus,the AED response network server 20 knows both (a) where the AED islocated, and (b) that it is in good working order with a high degree ofconfidence and such units can be displayed on the AED in a manner thatindicates that high degree of confidence—as for example by showing theicon 318 that represents the AED on the AED map in a first color—such asred. If it is determined that the AED is not in good working order forany reason, then the AED can be removed from the AED map so thatpotential users aren't encouraged to go to find an inoperable AED.Similarly, if its location cannot be self-verified, the AED can beremoved from the AED map unless its location can be verified by othermeans.

A second level of confidence may be applied to devices that are notthemselves connected devices with location identifying capabilities butwhose location and functionality can periodically be verified. One wayto do this is to require the owner or an administrator to periodicallypair a mobile phone or other mobile device executing a defibrillator appwith the AED unit to serve as a conduit for transmitting informationbetween the unit and the server. A wide variety of information can betransferred in this way, including, for example, communicating updateddiagnostics reports to the server that can verify that the reportingdevice is still in good working order. For such devices, the location ofthe AED can be determined by the location of the paired device. Ofcourse, the functionality and location of such devices can be verifiedin other suitable ways as well. In some implementations, devices thathave relatively recently had both their functionality and their locationverified can be shown in a second color—such as gray—on the AED map tographically indicate the level of confidence the server has that thedevice is both functional and present at its designated location.

A third level of confidence may be applied to devices that are notcapable of communicating their functional state to the server. Thelocation of such devices can be reported by interested parties in anysuitable manner—and such devices might be presented on the AED map in athird color or format. Of course, when appropriate, other categories orlevels of confidence can be envisioned and represented on the AED map inany desired manner.

Emergency Call Center Integration

As suggested in some of the discussion above, there can be significantadvantages to integrating the AED responder network with emergency callcenters and such systems have been generically proposed in the past.However in practice, there are significant barriers to implementing suchsystems. One practical barrier is that there are a large number ofemergency dispatch centers run or overseen by a wide variety ofdifferent entities. Therefore, they aren't standardized in theirorganization, processes and/or contracting practices. For example,different call centers may utilize different call handling processes,different event coding and/or may classify and structure event data indifferent ways. Still further, they may use different CAD system andtheir externally available APIs are not standardized.

The architecture proposed in FIG. 1B is particularly well suited forovercoming many of these barriers. Specifically, there are currentlyemergency service interfaces such as RapidSOS which provide an interfacefor providing a link for transmitting data from connected devices 29 toemergency services. Such interfaces have already integrated with (or arein the process of integrating with) a significant percentage of theemergency dispatch centers. In the embodiment of FIG. 1B, the AEDNetwork Server 20 communicates with the emergency call centers 25through the emergency services interface 28 which significantlysimplifies the call center integration process.

In some implementations, the CAD system user interface is modified toinclude an Activate AED Network GUI widget that when selected, sends anActivate AED Network message to the emergency services interface 28. Theemergency services interface 28, in turn forwards the Activate AEDNetwork message (which serves as a request for AED assistance) to theAED responder network server 20. In some embodiments, the Activate AEDNetwork widget takes the form of a GUI button that is displayed on anincident report screen of the CAD system. However, it should beappreciated that the widget can be implemented using a wide variety ofdifferent GUI mechanisms including pull down menus, etc., and can bedisplayed or accessible from any suitable UI screen.

The Activate AED Network message may take a variety of forms butgenerally includes at least the location (e.g., GPS coordinates, astreet address or other suitable location information) of the incident.Preferably the message also can include notes that may be entered by theemergency operator. The notes may indicate further relevant detailsabout the incident. For example, this may include further locationinformation (e.g., the victim is located on the 3^(rd) floor in suite340), details about the incident (e.g., beware of downed electricalwires), information about the victim or the victim's condition, or anyother information deemed appropriate. In some embodiments, the ActivateAED Message may have any number of other fields deemed relevant.

When the emergency services interface 28 receives an Activate AEDNetwork message from a CAD system, it forwards the message to the AEDnetwork server 20 to thereby activate the AED response network. This canbe accomplished by simply forwarding the received message or by creatinga new message that including the relevant information.

The described architecture provides emergency operators with the abilityto easily activate an AED responder network (e.g. by selecting a buttonon their CAD display screen) without having to be concerned with detailsof the responder network itself. In the illustrated embodiment all thedevice management, tracking, validation, selection and notifications arehandled by the AED response server(s) 20 independently of the callcenter. It should be apparent that there will be many circumstanceswhere a volunteer responder can arrive at the scene of a cardiac arrestincident with a defibrillator more quickly than traditional emergencymedical services, which has the potential to improve incident outcomesin many circumstances.

Providing emergency operators with the ability to easily activate theAED responder network can have even bigger impacts in some specificsituations. For example, some emergency call centers function somewhatlike routing or triage centers in that they take incoming calls anddetermine what more specific call center the call is best routed to. Onesuch example, illustrated in FIG. 6, is a 911 center 25A that receivesincoming 911 calls, determines the type of emergency service that isbest suited for handling the emergency (e.g., fire, medical, police) andthen forward the call to a call center specific to that service (e.g., afire call/dispatch center 61, a medical call/dispatch center 62, apolice call/dispatch center 63, etc) but does coordinate the dispatch ofemergency services itself. Although such frameworks are not too common,they do exist, and they are more often found in somewhat rural areas.

It should be apparent that such “call forwarding” can add additionaldelays to the response time—particularly when the receiving servicespecific call center (e.g. the medical call/dispatch center) happens tobe busy. Such delays can be particularly problematic in cardiac arrestsituations where every minute that passes before a responder arrives canadversely affect survival chances.

In such circumstances the receiving 911 center 25A can activate the AEDresponder network when the incident is categorized as a potentialcardiac arrest incident. This can help reduce any delays associated withwaiting for the call to be answered/acted on by the medicalcall/dispatch center 62 since volunteers in the AED responder networkmay be notified generally in parallel with the call forwarding whichincreases the possibility that a volunteer responder may arrive at thescene with an AED before traditional emergency services can arrive.Furthermore, in some specific instances, an alternative emergencyservice (e.g. a fire department with EMT services) may elect toparticipate in the AED responder network. In such circumstances, thealternative emergency service could actually receive notification of anearby emergency cardiac arrest incident sooner through the AEDresponder network than they would through the ordinary dispatchprotocol.

The emergency services interface 28 can also be used to facilitatetransferring information to emergency services from an AED or from auser app 35 using IP communication protocols. For example, either adefibrillator app/user interface or a user app 35 can include amechanism for contacting an emergency operator/dispatcher. An example ofsuch a mechanism is Contact Emergency Services button 345 shown in FIG.3E. As previously discussed, the AED may have a secure and validatedconnection with the AED response network server 20. When a user selectsthe contact Emergency Services button, a Contact Emergency Servicesmessage is sent to the AED response network server 20. The message mayinclude the devices location, or the location may be added by the serversince the server tracks the AED's location. The server, in turn, sends arequest to contact emergency services to the emergency servicesinterface 28 which, among other things is designed to identify thecorrect emergency call center and forward the request to the appropriatecall center.

Incident data can be transferred from an AED to an emergency call centerfor forwarding to emergency medical personnel in substantially the samemanner. As will be appreciated by those familiar with the art, duringemergency use of a defibrillator, the defibrillator collects a varietyof incident related information that may be useful to respondingemergency medical personnel. Relevant defibrillator information caninclude information such as the number of shocks delivered (if any); thecharacteristics of such shocks (e.g., the voltage applied, the waveformapplied, etc.); the timing of such shocks; the patient's measure ECGs(both before and after the delivery of a shock), etc. Although suchinformation may be useful to medical personnel, as a practical matter itcan be very difficult to convey such information to the medicalpersonnel. One obstacle is that most AEDs don't have a mechanism forelectronically sending incident information in real time during or afteran incident. Even if an AED has the ability to send incident data to anAED network server, the server typically wouldn't have visibility as towhat EMT team is responding to an incident and/or what medical facility(e.g. hospital) the patient may be taken to.

In contrast, in many circumstances, a call center will have a mechanismin place to deliver data or electronic information to both respondingemergency personnel and/or to medical facilities to which a patient maybe directed. Furthermore, emergency services interfaces such as RapidSOSare designed to deliver device data to the appropriate call center.Therefore, the AED response network server 20, the emergency servicesinterface 28 and the appropriate call center can together form aneffective intermediary for delivering defibrillator incident data toappropriate medical personnel. Such information can be delivered in realtime during an incident and/or shortly after the AED has been used.

FIG. 7 is a flow chart that illustrates the flow of information from adefibrillator to medical personnel and/or facilities via the networkserver 20, emergency services interface 28, a call center 25. As seentherein, the defibrillator transfers the relevant incident data to thenetwork server 20 (block 650). The network server then forwards theincident data to the emergency services interface 28 (block 652). Theemergency services interface, in turn, forwards the incident data to theappropriate call center (block 654). Finally, the call center forwardsthe incident data to the appropriate medical personnel and/or medicalfacilities (block 656).

Using the AED network server and emergency services interface asintermediaries in communications between the AED and emergency serviceshas several advantages both in implementation ease and overall security.The security is enhanced because the AEDs are known an authenticated bythe AED response network server 20. The AED response network server isknown and trusted by the emergency services interface 28. The emergencyservices interface is known and trusted by the emergency call centers25. From the perspective of the call center, any communications receivedover an IP connection from an AED are received from a trusted source(the emergency services interface), which can be white listed.Similarly, from the perspective of the emergency services interface 28,all data received over an IP connection from an AED are received from atrusted source (the AED response network server 20, which again can bewhite listed). In contrast, allowing call centers to accept connectionsfrom AEDs without going through the AED response network server wouldintroduce a significant security risk to the call centers.

The described approach is also particularly easy to implement becausethe emergency services interface 28 is already a trusted data providerfor many call centers, which significantly simplifies the AED responsenetwork/call center integration process.

It is noted that the described usage of the emergency services interfaceis believed to be quite different than emergency services interfacesthat are presently commercially available. Initially, the inventors areunaware of any existing emergency services interfaces that connect anAED response network to various emergency call center CAD systems asdescribed herein.

Further, some call centers are configured to send data (e.g., anelectronic incident record) to EMS providers 27. However, the inventorsare unaware of any existing emergency services interfaces thatfacilitate transferring incident information (e.g., the location of anincident) from a call center to a remote device (or a remote network ofdevices) that is not a part of the EMS network. Rather, in traditionalsystems incident data from remote devices 29 is only transmitted to EMSproviders 27. In contrast, as described above, in the architectureillustrated in FIG. 1B, the call center 25 can send a message to the AEDresponder network via the emergency services interface 28.

Other Features

Although only a few embodiments of the invention have been described indetail, it should be appreciated that the invention may be implementedin many other forms without departing from the spirit or scope of theinvention. For example, the drawing show a variety of specific screenshots from a user interface suitable for implementing selectivefeatures. However, it should be appreciated that the specific layout,text and graphics displayed may be widely varied based on the designneeds and preferences for any particular implementation. In manycircumstances GUI buttons or other GUI specific constructs are shown asthe user interface mechanism for inputting information or selectingspecific features. It should be apparent that the specific GUIconstructs used to implement the described functionality may be widelyvaried and in some embodiments, some of the transitions and/or updatesmay be implemented automatically based on detected or receivedinformation such as the location of the responder or responding AED, thearrival of other responders, etc.

In the discussions above, there are a number of alerts and messages thatare delivered to or from a volunteer responder, a connected AED, anincident bystander utilizing and AED app, etc. Such alerts and/ormessages may be transmitted via any of a variety of different messagingtechnologies, including SMS text messages, other text or voice messagingprotocols, multimedia messaging protocols (e.g., MMS), instant messagingor iMessage technologies, IP protocols (e.g., TCP/IP) and communicationstechnologies built thereon such as e-mail, etc., and/or using any othersuitable communications protocol.

Communications between the AED response network server(s) and emergencyservices servers or emergency response networks can also be made usingany suitable communications protocol.

Much of the discussion above refers to communications between an AED andan AED network server. Some AEDs will have an integrated communicationsunit so that communications can be made directly with the AED. Howeverin many other applications, the AED itself will not have acommunications unit that is suitable for communicating with the AEDnetwork sever. Rather, a separate interface unit or communications unitmay be provided that has such abilities. In some circumstances, theinterface unit may be a very separate unit that is physically attachedto a fully functional AED such that it can be (and is intended to be)carried together with the AED as a single unit even though it isarchitected as a modular system. In such circumstances, the AED (whichmight be considered a base defibrillator unit) may be a fully functionaldefibrillator that is capable of (and/or designed to) operateindependently with or without the presence of the interface unit. Insuch circumstances the described communications may be with theindependent interface unit or communication unit rather than the basedefibrillator unit itself. A good example of such a modular system isdescribed in the incorporated U.S. patent application Ser. No.16/145,657. However, for the purposes of this disclosure and claims,communications with such systems is contemplated to be within the scopeof the described communications with an AED unless the context precludessuch interpretation.

In other applications, an interface or communications unit may be partof a dock, cabinet or other structure that an AED is stored in/on, butwould not be taken together with the AED to the scene of an incident.Many of the described responder network communications and functionalitycan be accomplished in these types of systems as well, although theability to communicate in such systems would presumably be lost when theAED is removed from its storage location. However, such systems wouldstill be able to communicate the location and status of the AED when theAED is present at its storage location and can generate the describednearby incident alerts. Thus, again, for the purposes of this disclosureand claims, communications with such systems is contemplated to bewithin the scope of the described communications with an AED unless thecontext precludes such interpretation.

Several of the workflows described above were described at least in partthrough the use of flow charts which suggest a particular order ofsteps. In some circumstances the order of events may be important assuggested by the context. However, in others various steps may bereordered or eliminated and other steps may be added without departingfrom the spirit and scope of the invention.

The inventions have been described primarily in the context of adefibrillator responder network of defibrillators and volunteers willingto respond to cardiac arrest incidents. However, it should beappreciated that a similar approaches and systems can be used inconjunction with responder networks involving other types of medicalincidents, treatments and/or devices. For example, there are a number ofsituations in which quickly delivering a particular publically availablemedication to a patient can have a significant positive impact on thepatient's outcome. One specific example is that an epinephrine injectionis often recommended for a patient suffering from a severe allergicreaction (anaphylaxis). Similarly, some public health organizationsrecommend public administration of Naloxone (or other similarmedications) to patients that have suffered an opioid overdose. In bothof these situations, the patient or bystanders around the patient maynot have immediate access to the required medication, but since theseare relatively widely distributed medications, others nearby may havesuch medications on hand. The described responder network approaches canbe used to facilitate notifying nearby volunteer responders and/orconnected devices (as for example a connected first aid kit or aconnected EpiPen) of the nearby incident in the same manner describedabove with respect to the defibrillator responder network.

In another example, in certain regions poisonous bites (e.g., snakebites, spider bites, etc.) are of concern and quickly administering ananti-venom can significantly increase survival chances. In such regions,the responder network can be used to inform nearby volunteer respondersand/or connected devices of the need for the anti-venom or antidote. Ofcourse, there are a wide variety of other situations where there may bea need for a medical instrument, a component of a first aid kit or amedication that at least some volunteer responders may have ready accessto and an appropriate responder network would be advantageous. Whendevices are involved, the device itself (e.g. a first aid kit, an EpiPenor other medical instrument) is connected then such devices can beintegrated in the same manner as the described defibrillators.Alternatively, the connected device may be a more generic item such as afirst aid kit, an anti-venom kit, a medical supply kit, a safety kitetc. that contains or potentially contains the required items. It shouldbe apparent that the described techniques can be used in suchcircumstances as well. Therefore, the present embodiments should beconsidered illustrative and not restrictive and the invention is not tobe limited to the details given herein, but may be modified within thescope and equivalents of the appended claims.

What is claimed is:
 1. A method of handling a request for assistanceusing an emergency services interface that is configured to communicatewith a multiplicity of different emergency call centers, the emergencyservices interface being further configured to receive real-timeincident data from connected devices and communicate the real-timeincident data directly to appropriate ones of the emergency callcenters, the method comprising: receiving at the emergency servicesinterface, the request for assistance from a first selected one of theemergency call centers, the request for assistance including a locationof an incident for which assistance is desired; and in response to thereceipt of the request for assistance, sending an incident networknotification message from the emergency services interface to aresponder network server, the incident network notification messageincluding the location of the incident, wherein the responder networkserver, is configured to identify and notify a set of devices of theincident.
 2. A method as recited in claim 1 further comprising, at eachdevice that receives the nearby incident message, generating a nearbyincident alert that indicates that there is an emergency incident nearbyfor which the device may be useful, wherein the nearby incident alertincludes at least one of an audio alert and a visual alert, the visualalert being displayed on a display screen associated with the device. 3.A method as recited in claim 1 wherein each of the devices in theidentified set of devices has recently provided its location andoperational status to the responder network server.
 4. A method asrecited in claim 1 wherein: the responder network server is configuredto send status inquiries to a multiplicity of devices in response toreception of the incident network notification message; and the set ofdevices to be notified is a subset of the multiplicity of devices thatwere sent and responded to the status inquiries.
 5. A method as recitedin claim 1 wherein the emergency services interface is RapidSOS.
 6. Amethod as recited in claim 1, wherein the devices in the set of devicesare defibrillators.
 7. A method as recited in claim 1 wherein thedevices in the set of devices include a kit that includes at least oneof: an anti-venom; an antidote; an opioid overdose treatment; amedicine; a bleeding suppression mechanism; and an epinephrine injector.8. A method as recited in claim 1 wherein the devices in the set ofdevices includes a device selected from the group consisting of a firstaid kit, a safety kit, an epinephrine injector and a medical instrument.9. A method as recited in claim 1 wherein each of the devices in the setof devices has an associated communication unit, the communication unitbeing configured to receive messages from and transmit messages to theresponder network server.
 10. A method as recited in claim 9 whereineach of the communication units are one of: a component of theassociated device; part of an interface unit that is detachably mountedon the associated device to form a unitary portable system; physicallyattached to the associated device; not physically attached to theassociated device; or part of a dock or cabinet that holds theassociated device.
 11. A method as recited in claim 6 wherein each ofthe defibrillators has an associated communication unit configured toreceive messages from and transmit messages to the responder networkserver, each of the communication units being one of: a component of theassociated defibrillator; part of an interface unit that is detachablymounted on the associated defibrillator to form a unitary portabledefibrillator system; or part of a dock or cabinet that holds theassociated defibrillator.
 12. A method as recited in claim 6 whereineach of the defibrillators has an associated communication unitconfigured to receive messages from and transmit messages to theresponder network server, each of the communication units being one of:physically attached to the associated defibrillator; or not physicallyattached to the associated defibrillator.
 13. A method of transmittingselected defibrillator incident data to an emergency call center, themethod comprising: at a defibrillator network server, electronicallyreceiving the selected defibrillator incident data; and electronicallytransmitting the selected defibrillator incident data from thedefibrillator network server to an emergency services interface that isconfigured to communicate with a multiplicity of different emergencycall centers and to electronically transmit the selected defibrillatorincident data to a selected emergency call center, the emergencyservices interface being further configured to receive real-timeincident data from a multiplicity of other connected devices andcommunicate the real-time incident data directly to appropriate ones ofthe emergency call centers.
 14. A method as recited in claim 13 furthercomprising electronically transmitting the selected defibrillatorincident data from the emergency services interface to the selectedemergency call center.
 15. A method as recited in claim 13 wherein theselected defibrillator incident data includes at least one ECG segment.16. A method as recited in claim 13 wherein the selected defibrillatorincident data includes an indication of a number of shocks delivered toa patient and information about the nature or timing of each such shock.17. A method as recited in claim 13 wherein a defibrillator thatgenerated the defibrillator incident data has an associatedcommunication unit configured to receive messages from and transmitmessages to the defibrillator network server, wherein the defibrillatornetwork server receives the selected defibrillator incident data fromthe communication unit, the communication unit being one of: a componentof the defibrillator; part of an interface unit that is detachablymounted on the defibrillator to form a unitary portable defibrillatorsystem; physically attached to the defibrillator; not physicallyattached to the defibrillator; or part of a dock or cabinet that holdsthe defibrillator.
 18. A method as recited in claim 13 wherein: adefibrillator that generated the selected defibrillator incident data isconfigured to communicate with a mobile communication device; and thedefibrillator network server receives the selected defibrillatorincident data from the mobile communications device.
 19. A method asrecited in claim 18 wherein the mobile communication device is acellular phone having a defibrillator support app installed thereon thatcoordinates communications with the defibrillator and with thedefibrillator network server.
 20. A method as recited in claim 13wherein the selected defibrillator incident data is received by thedefibrillator network server, electronically transmitted from thedefibrillator network server to the emergency services interface, andelectronically transmitted from the emergency services interface to theselected emergency call center in real time during emergency use of adefibrillator that generated the selected defibrillator incident data.21. A method of transmitting selected defibrillator incident data to anemergency call center, the method comprising: at a defibrillator networkserver, electronically receiving the selected defibrillator incidentdata generated by a defibrillator during emergency use of thedefibrillator; and electronically transmitting the selecteddefibrillator incident data from the defibrillator network server to anemergency services interface that is configured to communicate with amultiplicity of different emergency call centers and to electronicallytransmit the selected defibrillator incident data to a selectedemergency call center, the emergency services interface being furtherconfigured to receive real-time incident data from a multiplicity ofother connected devices and communicate the real-time incident datadirectly to appropriate ones of the emergency call centers' and whereinthe selected defibrillator incident data is received by thedefibrillator network server, electronically transmitted from thedefibrillator network server to the emergency services interface, andelectronically transmitted from the emergency services interface to theselected emergency call center in real time during the emergency use ofthe defibrillator that generated the selected defibrillator incidentdata.
 22. A method as recited in claim 21 wherein the selecteddefibrillator incident data is transmitted to the defibrillator networkserver by one of: a communications unit that is an integral part of thedefibrillator; an interface unit that is a separate unit that detachablyattached to the defibrillator; a communication unit associated with thedefibrillator that is not physically attached to the defibrillator; anda mobile communication device having a defibrillator support appinstalled thereon that coordinates communications with the defibrillatorand with the defibrillator network server.